Laparoscopic liver resection in the treatment of HCC with liver cirrhosis: would it provide superiority to conventional open hepatectomy?

Treatment of hepatocellular carcinoma (HCC) should focus on both curability and invasiveness. Liver resection is the ideal option for solitary or limited multifocal HCCs in patients with preserved liver function (1). The rate of HCC recurrence is known to be associated with cirrhosis progression. Surgical indications for HCC associated with portal hypertension remain controversial, however, liver resection could be one of option in selected patients with mild portal hypertension, considering the shortage of donors for liver transplantation (1). In this group of patients, careful consideration in surgical candidacy with assessment of hepatic functional reserve, as well as, management of portal hypertension are extremely important in order to avoid postoperative complications such as ascites and liver failure.